Ureaplasma urealyticum in Reiter's syndrome

J Rheumatol. 1994 May;21(5):877-82.


Objective: To evaluate the role of Ureaplasma urealyticum (Uu) in the pathogenesis of Reiter's syndrome (RS).

Methods: Infection with Uu was determined in 31 patients with RS and 28 patients with other arthritides by urethral, cervical and synovial fluid (SF) culture and by measuring anti-Uu serum antibody. Infection with Chlamydia trachomatis was determined by examining SF by a direct immunofluorescence technique, by a polymerase chain reaction and by measuring anti-C. trachomatis serum antibody. The proliferative response of SF and peripheral blood mononuclear cells (PBMC) to Uu antigens in patients with RS was compared to that of a control group. The effect that treatment of 6 patients with RS with ciprofloxacin had on repeated cultures, on titer of anti-Uu antibody and on mononuclear cell reactivity was measured sequentially.

Results: The colonization rate of Uu in patients with RS (74%) was significantly greater than in patients with other arthritides (14%). Genital C. trachomatis isolation and serum anti-C. trachomatis antibody were uncommon in both groups (11 and 13%, respectively). SF mononuclear cells of the patients with RS proliferated specifically in response to Uu antigens [up to 6.9 stimulation index (SI)], as did their PBMC (up to 14.5 SI). In some patients, high anti-Uu antibody titers were measured in the serum. Clinical remission was observed in 4 of 6 patients and correlated with eradication of Uu, decrease in antibody titers and disappearance of mononuclear cell reactivity to Uu antigens.

Conclusion: Our findings suggest that Uu might be a causative agent or a trigger in the development of sexually acquired RS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Antibodies, Bacterial / blood
  • Antibody Specificity
  • Arthritis, Reactive / complications
  • Arthritis, Reactive / microbiology*
  • Cervix Uteri / microbiology
  • Chlamydia trachomatis / isolation & purification
  • Female
  • Humans
  • Male
  • Middle Aged
  • Synovial Fluid / microbiology
  • Ureaplasma Infections / complications
  • Ureaplasma Infections / drug therapy
  • Ureaplasma Infections / microbiology*
  • Ureaplasma urealyticum / isolation & purification*
  • Urethra / microbiology


  • Anti-Bacterial Agents
  • Antibodies, Bacterial